Pancreatic Extramedullary Plasmacytoma Presenting as a Pancreatic Mass

Abstract

Extramedullary plasmacytomas (EMP) are a subcategory of plasma cell neoplasm that involves organs outside the bone marrow. Involvement of the pancreas is relatively rare, reported in only 2.3% of autopsies. Radiologic findings in plasmacytoma are nonspecific, but endoscopic ultrasound fine-needle aspiration is a fast and reliable technique to acquire a histologic sample for initial diagnosis. Recently, the use of fluorine-18 fluorodeoxyglucose PET/CT has been recommended in patients with active multiple myeloma and solitary plasmacytoma. We present an interesting case of primary EMP in the pancreatic body encasing the portal vein as well as the celiac artery, which was detected before the patient was diagnosed of multiple myeloma.

Solitary plasmacytoma of the pancreas: A rare case report

“…If these plasma cell neoplasms occur in organs outside of the bone marrow, they are referred to as extramedullary plasmacytomas, and most frequently arise in the upper respiratory tract, liver, spleen, or stomach [ 4 , 5 ]. Although rare, these tumors may be found in the pancreas, accounting for only 2.3% of extramedullary plasmacytoma cases [ 6 , 7 ]. Furthermore, approximately 80% of these tumors occur in the pancreatic head [2] and can be primary or secondary to MM, depending on blood serum markers or bone marrow involvement [8] .…”

“…Furthermore, approximately 80% of these tumors occur in the pancreatic head [2] and can be primary or secondary to MM, depending on blood serum markers or bone marrow involvement [8] . Solitary plasmacytomas of the pancreas are associated with poor prognoses, especially in patients over the age of 50 with a tumor size above 4 cm [7] .…”

“…To our knowledge, there is no standardized treatment for solitary plasmacytoma of the pancreas. However, since these tumors have radiosensitive and chemosensitive properties, a combination of surgery, chemotherapy, or radiation is generally used [7] . In cases such as ours, where the tumor is large and has a high risk of systemic involvement, surgeries are not often performed [1] .…”

Obstructive jaundice caused by pancreatic plasmacytoma secondary to multiple myeloma: A case report and literature review

“…20,22 Several studies have shown that secondary pancreatic plasmacytoma is associated with a poor prognosis, high mortality and shortened overall survival. 4,38,42…”